CMA sends mixed message on medicare.

The Canadian Medical Association elected Brian Day as its president-elect at its annual general council meeting in Charlottetown and it conveyed a mixed message on medicare. Unlike usual CMA elections, where a single nominee is presented by a designated provincial medical association and acclaimed by delegates at the annual meeting, Day faced opposition over his position on medicare.

The general council meeting also adopted motions asserting its support of the medical system, but delegates defeated a motion which called on the CMA to reject parallel private health insurance as being inconsistent with the principle. Access to healthcare should be based on need rather than ability to pay.

They also voted to:

* "encourage governments to use public-private partnerships to expand capacity";

* remove all existing rules that prevent physicians from working both in the private and public sector; and

* promote reform within the medicare system.

Danielle Martin, chair of Canadian Doctors for Medicare, said the CMA was sending out mixed messages on where doctors stand. "Doctors believe in the values of medicare," she said, "but they are frustrated by the glacial pace of reform."

Dr. Day, an orthopaedic surgeon, operates the controversial Cambie Surgery Centre in Vancouver, Canada's largest for-profit medical centre. The centre operates outside the medicare system.

His election was opposed by Vancouver family physician Jack Burak, who was supported by Canadian Doctors for Medicare, groups of residents and medical students. Day had the backing of specialist groups in British Columbia and Canada. The Canadian Health Care coalition, nurses groups and labour unions expressed negative opinions of Dr. Day, claiming that he supports a two tier, American style health care system.

Day told CMA delegates, "My support for universal health care is unequivocal. I totally reject the so-called U.S. system." He stated that he does not intend to promote private delivery of health care, but aims to cut waiting lists for all medically necessary services to promote better, faster care for all Canadians, regardless of their ability to pay. The Vancouver surgeon reiterates his beliefs that private delivery of care is a key component of Canada's health system in a public insurance program.

In 2003, Day told the Romanow. Commission on the Future of Health Care that he favors users fees and limiting medicare to "core services."

He also told the commission that, "Universality is a concept. that discriminates against lower socioeconomic groups, and Comprehensiveness has reduced access to essential services in order to cover less 'medical necessary' treatments."

Brian Day's term as president begins in August 2007.

Physicians per 1,000
population in selected countries,
1990 & 2004

                 1990   2004

Greece           3.4    3.9
France           3.1    3.4
United States    2.3    2.4
United Kingdom   1.6    2.3
Canada           2.1    2.1
Japan            1.7    2.0
Canada           2.1    2.1

Source: Organization for Economic
Cooperation and Development.